'Parents are gudlists!' Experiences of puberty and parent-child sexual communication in rural KwaZulu-Natal, South Africa

This paper explores young people's experiences of puberty and their perspectives on parent-child sexual communication in rural northern KwaZulu-Natal. In-depth individual interviews, focus group discussions, and participatory visual research methodology were employed with 18 and 19-year-old young women (n = 30) and young men (n = 16) attending three primary health care facilities and a local high school in Jozini municipality. The findings suggest a complex interplay between unequal gender and socio-cultural norms that results in divergent puberty experiences and ambiguous and inconsistent patterns of parent-child sexual communication. Young people referred to their parents as gudlists, a local colloquialism for someone who is evasive, vague, ambiguous and indirect. Lack of open parent-child sexual communication hinders discussion of healthy sexuality, neglecting the sexual and reproductive health education and needs of young people. Reflective of their desire for change, young women in particular contest current parenting norms and suggest returning to cultural practices linked to traditional forms of courtship and sexual communication among young Zulu people.

Using an intersectional life course perspective to understand familial environment and its impact on sexuality development among Asian American sexual minority college students

There is a dearth of research understanding the sexual health of Asian American adolescents, and even more so for those who identify as sexual minorities (lesbian, gay, bisexual, queer, asexual, and other sexual orientations). This study is a secondary qualitative analysis focused on young adults' recollections of their formal and informal sex education experiences in childhood and adolescence using a sub-sample of in-depth interviews from students who self-identified as both Asian and sexual minorities living in the USA (n = 9). Results were organised into three sections: (1) latent cultural factors (e.g. stigma surrounding sex, self-sufficiency, filial piety); (2) the downstream effects of latent cultural factors (e.g. sex-related discussions, rules disallowing dating, role of lateral family members); and (3) the impact of deficient familial sex-related discussions (e.g. Internet, resentment). Study findings underscore the links between identity concealment and relationship concealment that are unique to Asian sexual minority individuals. We suggest that interventions involving Asian American US youth and their families should be culturally informed and promote cross-generational sex-related discussion. Future research should further explore the role of chosen family and non-parental family members as a point of intervention as they can be helpful sources of informal sex education.

[Parental sex education and sexual risk behavior of daughters and sons: findings from the representative survey "Youth Sexuality"]

BACKGROUND

According to socialization theory, parental sex education should lead to increased sexual literacy in adolescents. However, current data for Germany is lacking.

RESEARCH AIM

Against this backdrop, the aim of the present study was to link for the first time the general conversations about sexuality in the family (research question 1, RQ1), and specifically parental contraception education (RQ2), with the sexual risk behavior of adolescents.

MATERIALS AND METHODS

The database is the ninth wave of the representative survey "Youth Sexuality" conducted by the Federal Centre for Health Education in Germany (BZgA). Data from all sexually active 14- to 17-year-old adolescents in the sample who provided information on their sexual behavior and whose parents reported on their sex education behavior were analyzed (N = 357). To answer the two research questions, logistic regression analyses were carried out with four central characteristics of adolescent sexual behavior.

RESULTS

The results showed that for both girls and boys conversations about sexuality in the family are positively correlated with (1) reached age of consent at first sexual intercourse, (2) a positive first sexual intercourse experience, (3) reliable contraception use, and (4) a low number of sexual partners (RQ1). The same pattern of results emerged for contraception education by parents (RQ2).

DISCUSSION

The positive correlations between parental sex education and less risky adolescent sexual behavior need to be further investigated with respect to the underlying causal mechanisms.

The Impact of Parent-Adolescent Communication on Reduction of Sexual Risk Possibility Among Adolescents: Findings from the Suubi-Maka Study

Sexual risky behaviors among adolescents and young people remain a major public health problem worldwide. This study examined the impact of parent-adolescent communication on adolescents' possibility to engage in risky behaviors. The study used baseline data from the Suubi-Maka Study (2008-2012) implemented in 10 primary schools in Southern Uganda. Binary logistic regression models were conducted to determine the association between parent-adolescent communication and sexual risk possibility. Results indicate that gender [OR 0.220, 95% CI 0.107, 0.455], age [OR 1.891, 95% CI 1.030, 3.471], household size [OR 0.661, 95% CI 0.479, 0.913], and comfort level of family communication [OR 0.944, 95% CI 0.899, 0.990] were significantly associated with lower levels of sexual risk possibility among adolescents. There is a need to build interventions that make it easy and comfortable for adolescents to have open discussion and communication with parents on sexual risk possibility, risky behaviors, and risky situations.

Parent-Child Sexual Communication Frequency and Adolescent Disclosure to Mothers About Sexuality: The Moderating Role of Open Communication in a Common Fate Structural Equation Model

Although frequent and open parent-child sexual communication (PCSC) has been shown to yield positive effects on adolescent sexual health outcomes, most PCSC is one-sided and parent dominated rather than ideal communication characterized by openness. Adolescent children's disclosure of sexual feelings and behaviors to parents can prompt parent-child sexual communication (PCSC) and help parents tailor PCSC to children's needs, increasing the effectiveness of PCSC in promoting positive sexual outcomes. However, very little work has been done exploring correlates of adolescent disclosure about sexuality. Thus, the current study explored the associations between frequent PCSC and child disclosure and secret keeping, and whether open PCSC moderated the relationships. The sample included 603 mother-child dyads from the United States. Adolescent children were 12-17 years old (M = 14.55, SD = 1.68), White (55.6%) and cisgender female (49.8%). A common-fate SEM model revealed that PCSC frequency was positively associated with adolescent disclosure and adolescent secret keeping. However, when PCSC was open, PCSC frequency was associated with a decrease in adolescent secret keeping and an increase in adolescent disclosure. We discuss the importance of encouraging both open and frequent PCSC, as their interaction is related to increased adolescent disclosure and less adolescent secret keeping.

Cultural values influencing iTaukei women's discussion of family planning in the home

Pacific Sexual and reproductive health is influenced by cultural taboos and sensitivities. Although Pacific values are integral to family planning, open communication in the home is often difficult in the face of changing socio-cultural norms. This study explores the experiences of iTaukei Pacific women living in Fiji and Aotearoa New Zealand, and their discussion of family planning within the family setting. The study utilises talanoa methodology to understand women's realities and their navigation through shifting sexual and reproductive norms in both countries. The study found that although family may be seen as a place of 'truth' in which appropriate, culturally sensitive family planning communication should be available, this was challenged by cultural taboos or tabu which were persistent in family planning discussions. The study calls for greater reliance on holistic approaches to Pacific family planning perspectives and a greater examination of vā or the spaces within which Pacific women's experiences are negotiated and informed.

How Parents' Ideals are Offset by Uncertainty and Fears: A Systematic Review of the Experiences of European Parents regarding the Sexual Education of Their Children

Parents have a critical role to play in the sexual education of their children. We conducted a systematic review of studies assessing the experiences of parents regarding the role they play in the sexual education of their children. We included qualitative, quantitative, and mixed methods studies conducted among parents in Europe. We searched PubMed, Web of Science and Scopus, and screened 20,244 unique records. Forty-nine studies enrolling 18,083 unique parents met inclusion criteria. The studies show that parents have ideals regarding the sexual education of their children that center around the importance of trust, open conversations, and honesty. However, challenges and concerns, related to parents' and children's gender, children's age, children's specific situations, and limited parental knowledge and communication skills prevented them from living up to these ideals. Parents pointed to the role of other institutions as ways to support and strengthen parents' contributions to the sexual development of their children. We conclude that parents may require guidance and support to identify what is appropriate sexual education for their children, based on age, gender, and other characteristics, how to provide appropriate sexual education, and to strengthen their sexual communication skills and knowledge of contemporary sexual health issues.

"Keep Talking to Me": College-Attending Women's Desires for Support from Mothers, Fathers, and Friends/Peers in Healthy Sexual Decision-Making

Emerging adulthood (ages 18-29) is a transitional life stage characterized by changes in identity and sexual development, including navigating new sexual experiences and cultures. During this transitional period, emerging adult women often continue to seek the support of their parent(s), while also increasing their reliance on friends/peers. However, little is known about what specifically college-attending emerging adult women desire from these support systems when it comes to making healthy sexual decisions. Using thematic analysis, we examined what emerging adult women (N = 192) identified as support they desire to receive from mothers, fathers, and friends/peers in making healthy sexual decisions while in college. Overall, the majority of participants reported desires to receive some form of sexual support from the majority of sources. There were four themes of desired support across sources: (1) Advice and Communication, (2) Nothing, (3) Emotional and Tangible Support, and (4) Attitude Shifts. Differences in types of desired support were also found across different sources with participants reporting desires for emotional support from their mothers, no desired support from their fathers, and direct interventions from their friends. Implications for informing sexuality educators and programs are discussed.

How Sexual Information Sources are Related to Emerging Adults' Sex-Positive Scripts and Sexual Communication

Prior research suggests that parents, peers, and media are popular sources of sexual information and beliefs among emerging adults. Sex-positivity is an orientation toward sex that emphasizes open-minded beliefs and communication about varying sexual behaviors, preferences, and orientations. The current study investigated whether these sexual information sources were associated with emerging adults' endorsement of sex-positive and sexual orientation-related sexual scripts, and if these sources and scripts were associated with sexual communication among a sample of college students ages 18-22 (n = 341). Results indicate that learning from television was positively related to sex-positive sexual script endorsement, and that sex-positive scripts were associated with more positive sexual communication. An interaction also emerged between gender and learning from television on sex-positive script endorsement, and between gender and learning from social media on sexual orientation-related script endorsement. The implications of these findings are contextualized within emerging adults' sexual agency and behavior. Future directions of research are also discussed.

Mothers of Adults with Intellectual Disabilities: Experiences, Perceptions and Influences on Their Sons’ and Daughters’ Romantic and Sexual Lives

Individuals with Intellectual Disability (ID) value romantic and sexual expression, however often face barriers to developing relationships. Family caregivers play a significant role in supporting them with such matters throughout adulthood. In order to understand how to best support individuals with ID in this sphere of their lives, it is therefore essential to investigate family caregivers’ perceptions, influences and experiences. This study explored the views and experiences of nine mothers of adult individuals with mild and moderate ID in relation to their children’s romantic and sexual lives. Data was collected using semi-structured interviews and analyzed using Interpretative Phenomenological Analysis. Findings suggested that mothers held positive, but sometimes ambivalent, attitudes towards their children’s romantic and sexual lives. They assumed the dual role of a facilitator and a protector, and although they generally expressed a commitment to supporting romantic experiences, they viewed sexual experiences with caution due to fears relating to vulnerability and risk. In the context of vulnerability, although most participants described their children’s sexual knowledge as poor, they reported lack of preventative sexual or contraceptive education delivered at home. Participants hoped that their children would manage a long-term relationship, however also experienced a sense of loss related to the realization that this might not be possible. The findings of this study highlight the need to help mothers to proactively support their adult children in building sexual knowledge. This, in turn, can reduce individuals’ vulnerability and improve their ability to make informed choices. Suggestions for future research are also discussed.

“It Gives Me, as her Caregiver, a Sense of Security.” Young People with Intellectual Disability and Their Experiences with Sexuality, Menstruation, Gynecological Treatment and Contraception: A Follow-up Analysis of Parents’ and Caregivers’ Perspectives

Background

Research shows that caregivers support but also impede people with intellectual disabilities from developing intimate relationships. People with intellectual disability experience coital sex later and less often compared to adolescents without disabilities. Caregivers often request hormonal contraception from gynecologists on their behalf. Their main motives are pregnancy avoidance (either as a result of consensual sex or sexual abuse) and menstrual suppression.

Method

The sample included 42 primary caregivers of young people with intellectual disability aged 14 to 25. Interviews were evaluated with qualitative content analysis.

Results

Nine of the main caregivers assumed that sexual intercourse had taken place. Half of the carers evaluated the importance of sexuality for the young people with intellectual disability as high. The main reason for seeing a gynecologist was the prescription of hormonal contraceptives; the outcome of which was arbitrary and dependent on the individual gynecologist. The majority of young women took general hormonal contraceptives as a preventive measure or due to heavy bleeding, regardless of sexual activity. One-fifth took hormone depots as a form of long-term contraception.

Discussion

A trusting relationship with the gynecologist favored the compliance and well-being of the young women. The administration of hormonal contraceptives seems to be controlled by third parties. Caregivers used hormonal contraceptives to simplify the regulation of menstruation and felt relieved by it. Carers view the sexual activities of the young women more critically because they fear a pregnancy and the responsibility for a potential grandchild. The use of hormonal contraceptives made carers clearly more tolerant of sexual activity.

Dysfunctional Parent-Child Communication About Sexting During Adolescence

Sexting (sending, receiving, and forwarding nude, semi-nude, or sexually explicit content) entails risks for adolescents; therefore, it is important for parents to be able to communicate with their children about its implications. The goal of the present study was to identify parental characteristics that lead to dysfunctional communication (lower quality of communication) about sexting, on a sample of 427 parents (336 mothers and 91 fathers) of Israeli adolescents aged 10-18 years and to determine whether parents' perceived severity of sexting and the degree to which they perceive their adolescent to be susceptible to sexting function as mediating factors. Parents completed a set of questionnaires online. Findings indicated that authoritarian and permissive parenting styles were positively associated with dysfunctional parent-child communication about sexting. Authoritative style was inversely related to dysfunctional communication and was mediated by positive attitudes toward sex education. Additionally, authoritative parents were capable of assessing the severity of their children's sexting activities, and the degree to which their children were susceptible to engage in sexting. The quality of the discussion initiated by authoritative parents appears to have enabled them to be aware of adolescent behaviors and to adjust their communication about the inherent risks. Findings suggest that the perception of sexting as too risky diminishes parents' ability to conduct a high-quality discussion about it. In conclusion, research findings emphasize parents' role in mediation of the online experiences of their children and conducting a constructive discussions with them about sexting.

Higher parental socioeconomic status accelerates sexual debut: Evidence from university students in Italy

In this paper we analyze how the timing and type (protected or unprotected) of sexual debut are influenced by parental socioeconomic status (SES). We argue that depending on whether a "parental control" or a "cultural openness" mechanism prevails, one could find a postponing or an anticipating effect of higher parental SES on children's timing of sexual debut. By applying event-history techniques to unique data from the two releases of the Sexual and Emotional Life of Youths survey (2000 and 2017), we found a clear accelerating effect of higher parental SES-parental education and father's social class-on the sexual debut of Italian university students. The effect is partly mediated by family characteristics related to the cultural openness mechanism, such as low parental religiosity, greater communication about sex, and parental permissiveness; on the contrary, we only found weak support for the parental control explanation. Higher parental education is associated with a higher likelihood of protected first sexual intercourse-and especially of condom use-even if more precocious. Our results dispute the North American- and Anglo-Saxon-driven finding that high-SES children postpone their sexual debut.

Parental Mediation of COVID-19 News and Children's Emotion Regulation during Lockdown

The COVID-19 outbreak resulted in a large amount of emotionally charged messaging that is believed to have a tremendous psychological impact, particularly on children and early adolescents. The present study examined the relationships between children's exposure to COVID-19 news, children's emotional responses to the news, parental styles of mediating COVID-19 news, and children's emotional functioning during the COVID-19 lockdown in Italy in April 2020. An online survey was completed by 277 parents (Mage = 43.36; SDage = 4.76; mothers = 89.5%) with children aged 6 to 13 years. Regression analyses showed that the parental active mediation style was associated with higher emotion regulation and lower lability/negativity, whereas the restrictive style was associated with higher lability/negativity and the social coviewing style was associated with lower emotion regulation. The results provide evidence for how adults using an active style can mediate messages to reduce children's emotional difficulties during events with high emotional involvement.

Young People with Intellectual Disability and Their Experiences with Intimate Relationships: a Follow-up Analysis of Parents’ and Caregivers’ Perspectives

Background

Research shows that people with intellectual disability both want and benefit from relationships. Caregivers play an important role in the development and maintenance of these relationships. Barriers to relationships include lack of privacy, inadequate sex education, and lack of public transportation.

Method

The sample included 42 primary caregivers of young people with intellectual disability aged 14 to 25. Interviews were evaluated with the qualitative content analysis.

Results

Two-thirds of the caregivers reported the young people having had at least one relationship. The caregivers tended to minimize the importance of the young people’s relationships and reported, in equal measure, both positive and negative relationship skills. Caregivers described limited choice in terms of partner selection, lack of social opportunities, and low quality couple time. Parents face the detachment process with ambivalence and wish for a stable partnership for their children in the future.

Discussion

Young people with intellectual disability face barriers and limitations regarding intimate relationships. Some young people may keep their partnerships secret to avoid possible restrictions from their caregivers. Their time together is quantitatively high, but qualitatively poor due to a lack of transportation and inclusive services. Caregivers need to support the young people’s autonomy and take their relationships more seriously.

Talking About Sexting: Association Between Parental Factors and Quality of Communication About Sexting With Adolescent Children in Jewish and Arab Society in Israel

Sexting (sending and receiving sexual messages online), a legitimate means of communication if there is mutual consent, may put adolescent users at risk. Hence, parents must be able to address their children's sexuality and be capable of mediating the implications of sexting for them. Cultural differences may play a role in this important discourse. The current study sought to identify parental factors that lead to low-quality communication about adolescent sexting in Jewish and Arab societies in Israel. Participants included 427 Israeli parents (Jewish N = 242, 56.7%, Arab N = 185, 43.3%) who answered seven online questionnaires. Results revealed ethnic differences between Arab and Jewish parents with regard to the quality of parent-child communication about sexting. Arab parents tended more toward low-quality communication about sexting than did Jewish parents. Perceived severity of sexting and perceived susceptibility to sexting led to more low-quality communication by Arab than by Jewish parents. Mothers in both societies were better able to mediate sexting and displayed higher parental efficacy than did the fathers. These findings provide useful insights for therapists and parents into the link between parental factors and the quality of communication about sexting with adolescent children.

Parent-adolescent communication on adolescent sexual and reproductive health in sub-Saharan Africa: a qualitative review and thematic synthesis

Background

Improving adolescent sexual and reproductive health continues to be a global public health need. Effective parent–adolescent communication on sexual health issues has been cited as a factor that could influence adolescents towards adopting safer sexual behaviour. The current review synthesises qualitative literature to understand the nature and relevance of parent–adolescent sexual and reproductive health communication and the barriers to effective communication in sub-Saharan Africa.

Methods

We systematically searched and synthesised qualitative literature published between 1st January 1990 to December 2019 and searched from CINAHL, PsycINFO, MEDLINE, Global Health, EMBASE, PubMed, and Google Scholar. We assessed the methodological quality of included studies using the Critical Appraisal Skills Programme (CASP) checklist. We thematically analysed qualitative data from the included primary studies.

Results

Fifteen studies were included. Social and physiological events act as triggers for initiating discussions. Fear of personal, social, and economic consequences of high-risk sexual behaviours act as drivers for communication but also carry a negative framing which hinders open discussion. Lack of parental self-efficacy and cultural and religious norms create an uncomfortable environment leaving peers, media, teachers, and siblings as important and sometimes preferred sources of sexual health information.

Conclusions

While mothers recognise their own role in adolescent sexual and reproductive health and school-based interventions can act as useful prompts for initiating discussion, fathers are mainly absent from home-based dialogue. Fear dominates the narrative, and the needs of adolescents remain unarticulated.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12978-021-01246-0.

Improving adolescent sexual and reproductive health remains an important public health need globally. Effective communication on sexual health issues between adolescents and their parents has been recognised to influence safer sexual behaviour among adolescents. This review combined qualitative evidence to understand the nature of, and barriers to communication about sex between parents and adolescents in sub-Saharan Africa.

We searched academic databases for relevant articles published between January 1990 and December 2019 and found 15 studies of appropriate quality. Data on parents and adolescents’ experiences of sex communication in these studies was synthesised. Drivers for sex communication including fear of personal and economic consequences were highlighted. Results also identified barriers to communication such as cultural and religious norms and lack of parental knowledge and skills.

Findings showed that adolescents sometimes prefer other sources of sexual health information like peers, media, and siblings. Mothers are recognised to be more involved with home-based interactions on sexual health with adolescents compared to fathers. The results of this review point to the necessity for adolescents’ needs to be understood and articulated towards influencing policy and programmes.

Adolescents in sub-Saharan Africa remain at high risk for sexually transmitted infections, female genital mutilation, and early pregnancy.

Adolescents mostly view sex-related discussions with parents as uncomfortable, and interactions are driven by fear of personal, social, and economic consequences of sexual risk-taking behaviour.

Parents recognise their lack of capacity to engage with adolescents and are influenced by cultural norms and religious beliefs.

Future research needs to address the current imbalance of adult versus adolescent voices in published work and also ensure a creation of space for conversations about sexuality with sexual and gender minority youth in the Lesbian, Gay, Bi-sexual, Transgender, Queer, Intersex, and Asexual communities.

Predisposing Factors and Impact of Child Victimization: A Qualitative Study

Sexual abuse of children is increasing at an alarming rate. This study aims to describe the risk factors and the effects of sexual abuse on children. This unobtrusive qualitative study was conducted on children aged 10 to 18 years old who experienced sexual abuse and followed-up at a psychiatric clinic between the years 2019 and 2021. The information from case records was transcribed. Thematic analysis was performed. Thirty case records were reviewed. The mean age of the victims was 14.6 years; 94% of the victims had experienced vaginal penetration, and 23% of the cases involved incest. The results indicated that socio-psychological predisposing factors involving family structure and dynamic dysfunction, low intrapersonal strength, social influence, and low family socioeconomic status could lead to sexual victimization. This sexual victimization can then lead to emotional turmoil, negative effects on cognitive, academic and social function, negative parental reactions toward the incident, the creation of baby–mother relationships and love–hate relationships, and a lack of goals and hope for the future. Children who experienced sexual abuse may show rape or pregnancy symptoms but may also show entirely non-specific ones. A thorough examination of their history, including biopsychosocial aspects, is necessary to appropriately care for them.

The impact of sexual education and socialization on sexual satisfaction, attitudes, and self-efficacy

This study examined the relation between school-based sexual education and parental messages about sex received in adolescence, and sexual attitudes and experiences in young adulthood. Participants—99 Canadian undergraduate students aged 17–25 years—reported that their sexual education largely focused on traditional topics (e.g., negative health outcomes, physiology, etc.), while social and emotional topics were less likely to be formally covered. Parental sexual socialization that was more comfortable and accepting of teen sexuality was related to more permissive sexual attitudes in young adults, but was unrelated to self-efficacy or sexual satisfaction. When all variables were examined using hierarchical regression, sexual education and parental socialization did not predict sexual satisfaction. However, mediation analysis revealed an indirect effect of sexual self-efficacy on the relation between sexual education and sexual satisfaction. More comprehensive and higher-quality sexual education increased sexual self-efficacy, which was then related to higher sexual satisfaction beyond the role of gender and relationship status. This provides insight into the mechanism by which sexual education in Canada may impact sexual satisfaction. The influence of parental socialization and school-based sexual education are apparent and complementary. Both sources of information and values (parents/school) offered benefits for young adults’ positive sexual attitudes, but school-based education appears to be key. How sexual education is delivered (e.g., if teachers are knowledgeable and comfortable discussing topics) may be even more important than the content itself. These findings suggest that prioritizing teacher training to improve their comfort with delivery of sexual education programming would improve adolescents and young adults’ sexual lives.

Efficacy of a Web-Based Intervention (Smart Choices 4 Teens) for Facilitating Parent-Adolescent Communication About Relationships and Sexuality: Randomized Controlled Trial

BACKGROUND

There is a need for interventions that promote healthy decision making among adolescents and leverage the ongoing impact of parental relationships through older adolescence and young adulthood. These interventions should maximize adolescent engagement and be easily accessible to families in terms of cost, duration, and logistics related to participation.

OBJECTIVE

This study aims to test the efficacy of the healthy relationships and sexual decision-making component of a web-based intervention for older adolescents and their parents, ascertain whether the efficacy varies by gender, and assess its efficacy over time.

METHODS

A randomized controlled trial was conducted for the web-based, self-paced intervention Smart Choices 4 Teens from 2014 to 2015. Families (N=411) with adolescents aged 16-17 years were randomly assigned to the intervention or control condition. Surveys assessing aspects of sexual communication were administered at baseline and at 6, 12, and 18 months. Generalized estimating equations were used to determine the impact of exposure to the relationships component of the intervention on sexual communication by parents, as reported by adolescents.

RESULTS

Less than half (88/206, 42.7%) of the intervention group participated in the third and final intervention component, which was focused on relationships and sexual decision making. Participation in the relationships component increased the frequency of parental sexual communication and increased the number of dating rules after accounting for other significant adolescent characteristics. The impact of the intervention varied little by gender, although it did demonstrate an impact on communication reports over the follow-up survey administrations.

CONCLUSIONS

Smart Choices 4 Teens demonstrated efficacy in increasing the frequency of sexual communication between parents and adolescents in the long term.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03521115; https://clinicaltrials.gov/ct2/show/NCT03521115.

"Knowledge I seek because culture doesn't work anymore … It doesn't work, death comes": the experiences of third-generation female caregivers (gogos) in South Africa discussing sex, sexuality and HIV and AIDS with children in their care

Background

Sexual reproductive health communication between parents and children has been shown to promote safer sexual choices. In many South African households, third-generation female caregivers, often grandmothers or other older females, locally known as gogos, are primary caregivers of children due to parents being deceased or absent. Subsequently, the responsibility of talking about sex and related issues has shifted to these gogos. This study explored the experiences of gogos living in Alexandra, Johannesburg on talking about sex, sexuality and HIV and AIDS with children aged 10–18 years that are in their care.

Methods

Ten primary caregivers were purposively selected. Data were collected through in-depth individual interviews. Thematic analysis was performed and inductive codes and themes identified.

Results

All gogos selected found it difficult to discuss sex, sexuality and HIV and AIDS due to culture and traditional values impacting on personal experiences as well as generation and gender barriers. Perceived low self-efficacy due to low levels of knowledge and limited skills in speaking about sex, sexuality and HIV and AIDS also contributed to low levels of sexual reproductive health communication.

Conclusions

This study highlights the need for interventions that focus on improving gogos’ knowledge about sexual reproductive health in addition to providing them with the skills to talk about sex, sexuality and HIV and AIDS with children in their care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10494-5.

Knowledge, Information Needs and Risk Perception about HIV and Sexually Transmitted Diseases after an Education Intervention on Italian High School and University Students

Sexually transmitted diseases (STDs) among adolescents and young people represent a significant public health problem that generates a pressing requirement of effective evidence-based education to promote primary and secondary prevention. The objective of the study is to evaluate how knowledge, information needs, and risk perception about HIV and STDs can change after targeted education interventions for students. A total of 436 subjects aged 15-24 attending high school (134 biomedical and 96 non-biomedical fields) and university courses (104 scientific and 102 non-scientific disciplines) were enrolled to respond to a questionnaire before and after the intervention. An improvement in knowledge was found in all groups, with statistically significant knowledge score differences between the four groups in 60% of the items. More than 94% of the students consider it useful to promote information on these issues. Receiving this information generated awareness and safety in more than 85% of high-school students and 93% of University students. Students widely perceived a great risk being infected with HIV/STDs, although pregnancy was seen as a more hazardous consequence of unprotected sex. This study shows that educational interventions are effective in improving knowledge, apart from findings about key knowledge topics, information needs, and risk perception, which provide significant insights to design future targeted education programs.

Home Base: Family of Origin Factors and the Debut of Vaginal Sex, Anal Sex, Oral Sex, Masturbation, and Pornography Use in a National Sample of Adolescents

Because early initiation of sexual behavior can lead to negative health outcomes, it is important to understand the influence of family of origin (FOO) on adolescent sexual debut. This brief report explores the relationship between time spent living with both biological parents, overall quality of FOO experience, and various sexual behaviors (vaginal sex, oral sex, anal sex, masturbation, and pornography use) in adolescence and emerging adulthood. We hypothesized that participants reporting higher quality FOO experiences and more time with biological parents would be (a) more likely to delay the debut of these behaviors and (b) less likely to have participated in these behaviors at all. A demographically diverse national sample of 2,556 18-19-year-old U.S. residents was surveyed. Results showed that more time with biological parents was associated with a lower likelihood of experiencing vaginal, oral, and anal sex. Across analyses, higher quality FOO experience was consistently associated with a lower likelihood of pornography access, masturbation, and oral sex and inconsistently associated with a lower likelihood of anal and vaginal sex. Higher quality FOO and more time with biological parents predicted delayed debut of pornography access, masturbation, vaginal sex, and oral sex. Implications for future research and practice are discussed.

Parent-child communication about sex and romantic feelings: does having older siblings make a difference?

Parental involvement in sex education and the quality of parent-child communication about romantic feelings appear to have a protective effect on adolescent sexual behaviours. However, little research has been conducted on the role played by birth order in the level of parental involvement in sex education. This is the first study seeking to address if the quality of parent-child communication about sex and romantic sentiments differs according to whether respondents have—or do not have—older siblings in Italy. Hypotheses concerning the role of sib-ship gender composition have been tested in order to explain potential intervening mechanisms. Data were drawn from the Sexual and Emotional Life of Youths survey (SELFY), a cross-sectional survey conducted in 2000 and in 2017 on Italian university students (N = 12,265). Our findings identify later-born children as the least likely to confide in parents. Although boys are generally less likely to talk to parents than girls, respondent gender does not moderate the effect of birth order. Instead, sib-ship gender composition plays a role: having grown up with at least one same-gender sibling is associated with a lower communication with parents about intimate matters. This study suggests that growing up with siblings, namely with same-gender siblings, make a difference in parent-child communication and this should be considered while evaluating the role of parental involvement in adolescent sexual education.

Family Sexuality Communication: Parent Report for Autistic Young Adults Versus a Comparison Group

Families are a critical context for healthy sexuality development. This study characterized family sexuality communication for autistic adults (age 18-30) without intellectual disability (n = 117) versus a neurotypical comparison group (n = 319). Parent-reported number of sexuality topics covered did not significantly differ by gender or autism/comparison group. Parents of autistic adults who covered few or no topics (31%) reported higher religiosity, lower comfort and self-efficacy, and were less likely to say that the adult expressed attraction or desire for relationships. Parents of autistic adults were more likely than comparison parents to perceive their young person as being uninterested or not ready to learn about sexuality topics. These results suggest that families of autistic people require support to convey sexuality-related knowledge and values.

Parent-child communication about sexual issues in Zambia: a cross sectional study of adolescent girls and their parents

Background

Parent-child communication about sexual issues can reduce risky sexual behaviour amongst adolescents. Risky sexual behaviour is of concern in sub-Saharan Africa where the prevalence of early pregnancy, unsafe abortion and HIV are high. Parent-child communication about sexual issues presents a feasible approach for reducing sexual risk amongst adolescents in sub-Saharan Africa but limited research exists from the region. This study from Zambia examines the sociodemographic and psychosocial factors that are associated with whether parents communicate with their daughters about sexual issues.

Methods

Data from a cluster randomized controlled trial examining the effect of interventions aiming to reduce teenage pregnancy and school drop out in Zambia was used. The data was collected between January–July in 2018 and consists of structured, face to face interviews with 4343 adolescent girls and 3878 parents. Cross sectional analyses examined the associations between parent-child communication about sexual issues and sociodemographic and psychosocial characteristics using univariate and multivariable logistic regression models.

Results

Adolescent girls who felt connected to their parents and those who perceived their parents to be comfortable in communicating about sex, were more likely to speak to their parents about sexual issues than those who did not (AOR 1.23, 95% CI 1.01–1.52; and AOR 2.94, 95% CI 2.45–3.54, respectively). Girls whose parents used fear-based communication about sexual issues, and those who perceived their parents as being opposed to education about contraception, were less likely to communicate with their parents about sex than those who did not (AOR 0.76, 95% CI 0.65–0.89; and AOR 0.76, 95% CI 0.63–0.91, respectively). Girls enrolled in school were less likely to communicate with their parents about sex than those out of school (AOR 0.56, 95% CI 0.44–0.71).

Conclusion

Parenting style, children’s perception of parental attitudes and parental communication styles are associated with whether parents and children communicate about sexual issues. This may imply that parents can improve the chances of communicating with their children about sex by conveying non-judgemental attitudes, using open communication styles with neutral messages and appearing comfortable whilst displaying positive attitudes towards communication around sex and contraceptive use.

Trial registration

ISRCTN registry: ISRCTN12727868, (4 March 2016).

Pathways to sexual health communication between adolescent girls and their female caregivers participating in a structured HIV prevention intervention in South Africa

RATIONALE

Interventions that promote sexual health communication between adolescents and their parents or other primary caregivers are an important tool for reducing female adolescents' behavioral risk. Understanding the mechanisms by which interventions effectively foster communication can inform future programs.

OBJECTIVE

An initial evaluation of Let's Talk, a structured, family-centered HIV prevention intervention for vulnerable adolescents in South Africa, found an increase in caregiver-adolescent sexual communication. This analysis expands upon initial findings to explore the role of parental knowledge, the quality of the parent-adolescent relationship, and the mental health of both parties on caregiver-adolescent sexual health communication.

METHOD

Using mixed methods data collected in 2015 and 2016, structural equation modeling of differenced pre- and postintervention survey data from 64 female Let's Talk participants ages 13-17 and their caregivers was used to explore the pathway to increased frequency of caregiver-adolescent sexual health communication. Focus group discussions (FGDs) were held with intervention participants (n = 25) and facilitators (n = 6).

RESULTS

The path analysis indicates that caregivers' mental health indirectly affected caregiver-adolescent relationship quality, and adolescents' mental health exerted a direct effect. Relationship quality, in turn, directly affected the level of parental sexual communication reported by the adolescent. FGDs suggested that cultural norms inhibit frank discussions between caregivers and adolescents about sexual health, but that thoughtfully designed interventions such as Let's Talk can mitigate this barrier. Qualitative findings also echoed quantitative findings about the role of caregiver-adolescent relationship quality and mental health on communication frequency and highlighted the importance of enhancing participants' technical knowledge and particularly their skills related to expression, listening, and anger management to help enable sensitive conversations.

CONCLUSIONS

Findings overall suggest that a holistic intervention approach emphasizing caregiver-adolescent relationship development and designed to support the mental health of both parties may hold significant promise for enhancing sexual health communication.

Innovation and Integration of Sexuality in Family Life Education

As a fundamental aspect of the human experience, sexuality is experienced at every stage in the lifespan. Sexual values, behaviors, and health are important components of individual and family well-being. Educating about such a fundamental aspect of life is both obvious and crucial. In this article, we consider the potential of sexuality education in the field and profession of family life education (FLE). We critique sexuality education in the United States, and we critique the marginal place of human sexuality in the FLE field. We then offer recommendations for incorporating lifespan, socio-ecological, family systems and intersectionality into sexuality education, and recommendations for FLE and sexuality education research and practice. We argue that educating about sexuality in the context of FLE-and activating the profession of FLE for sexuality education-will strategically advance sexuality education, sexual health, and the field of FLE.

Parenting Practices and Emerging Adult Sexual Health: The Role of Residential Fathers

Emerging adulthood is a developmental period with high rates of sexual risk behavior. Effective parenting practices can reduce the likelihood of this behavior, but most research on the protective effects of parenting focuses on mothers. Research is needed to assess the role of paternal parenting in regards to their children's sexual risk behavior, particularly for children of teen mothers, who show a greater likelihood of risky sexual behaviors than those with older mothers. We investigated associations between residential fathers' parenting processes-communication, disapproval of teen sexual behavior, parental presence, and closeness-during adolescence and sexual risk behaviors reported by their children in emerging adulthood. Using multiple group structural equation modeling with data from 7399 participants at Wave I and Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examined whether and how residential fathers' parenting relates to their children's sexual risk behavior independent of mothers' parenting processes, and whether these associations differ across children's sex and for children of teen and older mothers. We found that adolescents' perceptions of higher father disapproval of teen sexual behavior predicted lower levels of sexual risk behavior during emerging adulthood with no significant differences across emerging adults' sex or for children of teen relative to older mothers. Our findings suggest that teens' relationships with their fathers during adolescence are important for their future sexual health, despite a general understanding of emerging adulthood as a period characterized by independence and separation from parents. Additionally, our results suggest that even though children of teen mothers show greater likelihood of risky sexual behaviors than those of older parents, the processes through which fathers can support teens' sexual health may be similar.

Insight into Informant Discrepancies Regarding Psychosexual Functioning of Adolescents with and without Autism Spectrum Disorder

The private nature of psychosexual functioning leads adolescents and their parents to have different perspectives, which highlights studying parent-child informant discrepancies in this domain. We investigated informant discrepancy in psychosexual functioning, using the self-report and parent report versions of the Teen Transition Inventory (TTI), of adolescents with autism spectrum disorder (ASD; 136 parent-child dyads) compared to adolescents from the general population (GP; 70 parent-child dyads). Significantly larger informant discrepancies exist in ASD dyads than GP dyads in most domains of psychosexual functioning, except for Body image, Sexual behavior, and Confidence in the future. It is important to use and pay attention to both informants, as discrepancies are relevant for both research and clinical practice regarding psychosexual functioning.

Home-based sex communication, school coverage of sex, and problems in sexual functioning among adolescents

Young people experience problems in sexual functioning at high rates. Sexual health education (SHE) has been found to reduce risk for negative outcomes, yet research has not addressed how SHE is related to problems in sexual functioning among adolescents. The current study assessed how perceived quality of sexual education at home and quality of coverage of sexual health topics in school are related to sexual functioning among adolescents. Adolescents (N = 411, 16–21 years) completed measures of sexual functioning and related distress, sexual self-esteem, and school SHE and home-based sex communication. Lower sexual-self-esteem was related to higher odds of reporting a sexual problem as well as more distress about these problems. After controlling for sexual self-esteem, higher perceived quality of home-based communication with parents about sex was associated with lower odds of having one or more sexual problems (OR = .80), but higher odds of having distressing sexual problems (OR = 1.51) for male adolescents only. Quality of coverage of sex topics in SHE was unrelated. These findings suggest that home-based sex communication for male adolescents may be important for experiencing problems overall, but also may contribute to heightened distress should a problem occur. Results are discussed in terms of differential socialization by parents in communicating with sons and daughters about sex.

The Association Between African American Parent-Child Sex Communication and Adolescent Condomless Sex

African American adolescents are at elevated risk for HIV and sexually transmitted infections. Risk reduction efforts have focused on parent-child communications, despite inconsistent findings regarding their association with adolescent sexual risk behaviors. The present study included sexually active African American adolescents and their parents/guardians (N = 125 dyads). All participants reported on frequency of sexual health conversations and adolescents reported recent occasions of protected and condomless sex. Analyses examined the congruence between parent-child communication reports and the association between this congruence and adolescent condomless sex. Parents and adolescents disagreed on the frequency of sexual health communication: 30% of parents reported such conversations as frequent, whereas only 2% of adolescents did. Parent-reported sex communication was negatively associated with adolescent condomless sex, while adolescent-reported communication was not. The moderation hypothesis was supported in that adolescent-reported sex communication was negatively associated with adolescent condomless sex only among parent-child dyads high in agreement on sexual health communication. Promoting parent-child conversations regarding sexual health, with attention to relational characteristics of the conversations, offers a promising approach to sexual health promotion and disease prevention for African American youth.

Young adolescents' responsiveness to sexual communication with their mother: Distinguishing diverse intentions

INTRODUCTION

It is unlikely that parents can have effective sexuality discussions with their adolescent if the adolescent is not responsive to their efforts. We evaluated young adolescents' intentions of being responsive to sexual communication with their mother and whether youths who were likely, ambivalent, or unlikely to be responsive differed on their characteristics, features of previous sexual communication, and features of the mother-adolescent relationship.

METHODS

Participants were 259 Canadian adolescents (12-14 years; 53% girls) who received and returned a survey by mail. They completed measures of responsiveness intentions, expected outcomes of sexual communication, extent of past sexual communication, the frequency with which mothers encouraged questions and provided information about sexuality topics, open communication, and mothers' provision of warmth, structure, and autonomy support.

RESULTS

We found that 37% of adolescents were likely to be responsive to sexual communication with their mother, 34% were ambivalent, and 29% were unlikely to be responsive. Youths' responsiveness intentions were general rather than topic-specific. A discriminant analysis showed that only features of previous sexual communication separated all three groups whereas specific mother-adolescent relationship features (open communication and structure) and one adolescent characteristic (expected outcomes) separated the unlikely group from the other groups.

CONCLUSIONS

Young adolescents' intentions of being responsive to sexual communication from their mother are diverse yet general in nature. Mothers' engagement in sexual communication appears essential for youths' openness to these discussions. Enhancing specific mother-adolescent relationship features and youths' outcome expectations may shift adolescents who are resistant to sexuality discussions to being more sure.

Young women's reproductive health conversations: Roles of maternal figures and clinical practices

OBJECTIVE

To explore the role of clinical providers and mothers on young women's ability to have confidential, candid reproductive health conversations with their providers.

METHODS

We conducted 14 focus groups with 48 women aged 15-28 years (n = 9), and 32 reproductive healthcare workers (n = 5). Focus groups were audio recorded and transcribed. Data were analyzed using inductive coding and thematic analyses. We examined findings through the lens of paternalism, a theory that illustrates adults' role in children's autonomy and wellbeing.

RESULTS

Mothers have a substantial impact on young women's health values, knowledge, and empowerment. Young women reported bringing information from their mothers into patient-provider health discussions. Clinical best practices included intermingled components of office policies, state laws, and clinical guidelines, which supported health workers' actions to have confidential conversations. There were variations in how health workers engaged young women in a confidential conversation within the exam room.

CONCLUSIONS

Both young women and health workers benefit from situations in which health workers firmly ask the parent to leave the exam room for a private conversation with the patient. Young women reported this improves their comfort in asking the questions they need to make the best decision for themselves. Clinic leadership needs to ensure that confidentiality surrounding young women's reproductive health is uniform throughout their practice and integrated into patient flow.

Parent-Adolescent Communication About Sex and Condom Use Among Young Men Who Have Sex With Men: An Examination of the Theory of Planned Behavior

Background

Young men who have sex with men (YMSM) are at disproportionate risk for HIV infection. Parent-adolescent communication about sex, particularly mother-adolescent communication, protects against adolescent sexual risk behavior. However, it is unclear whether these findings generalize to YMSM.

Purpose

The current study used the theory of planned behavior as a framework to examine how YMSM perceptions of parent-adolescent communication about condoms are associated with determinants of condom use and condomless anal sex among YMSM.

Method

YMSM ages 14-18 (M = 16.55) completed an online survey (n = 838). Associations between several domains of parent-adolescent communication about condoms (i.e., frequency and specificity, quality, and negative emotionality) and condom-related attitudes, norms, perceived behavioral control, and intentions, as well as instances of condomless anal intercourse (CAI), were examined with structural equation modeling.

Results

Multiple facets of mother-adolescent communication were associated with attitudes about condoms, subjective norms for condom use, perceived behavioral control, intentions to use condoms, and indirectly, instances of CAI. Father communication was not associated with determinants of condom use behavior.

Conclusions

Parent-adolescent communication about condoms is associated with determinants of condom use behavior among YMSM, and mother communication exerted an indirect influence on HIV-related sexual risk behaviors. Interventions designed to enhance parent- adolescent communication about condoms could prove efficacious in reducing HIV infections among YMSM.

Youth Sexual Development: A Primer for Social Workers

Sexuality and sexual expression are core aspects of most clients' lives, yet most schools of social work fail to cover sexual development, leaving social workers uninformed about this essential area of human development. This is particularly the case when the sexual development of youths is concerned, as youth sexuality is often considered too controversial to explore. Considering a positive approach to youth sexuality that seeks to enhance youths' sexual development and promote their achievement of full sexual and reproductive rights, this article seeks to provide social workers with a resource they can use to enhance their understanding of youth sexual development and its applicability to social work practice. The two main theoretical orientations used to understand sexual identity development are covered as well as the research support for each. Following the explanation of theory is a discussion of how the two theoretical orientations can be integrated to form a more expansive base for the understanding of sexual identity development. A final section provides guidance on how an advanced understanding of youthful sexual identity development can enhance social work practice at the micro, mezzo, and macro levels.

Family functioning patterns predict teenage girls’ sexting

Online exchange of sexual content (“sexting”) is associated with potentially negative consequences, especially for girls. We investigated possible associations between family functioning and girls’ sexting. Italian teenage girls ( N = 250; Mage = 16.36 years; SDage = 1.88) completed online surveys that evaluated family functioning (communication, flexibility, cohesion, disengagement, chaos, enmeshment, and rigidity) and five sexting behaviors: (a) engaging in sexting, (b) sexting with a partner, (c) number of people with whom girls share sexts, (d) nonconsensual forwarding of sexts, and (e) sexting for emotion regulation. We found that engaging in sexting, sexting for emotion regulation, and the number of people with whom girls share sexts were predicted by age and low family communication. Sexting with a partner was predicted by age and high flexibility, and nonconsensual forwarding of sexts was positively predicted by enmeshment.

Adolescents' compulsive sexual behavior: The role of parental competence, parents' psychopathology, and quality of parent-child communication about sex

BACKGROUND AND AIMS

Compulsive sexual behavior (CSB) has implications for clinical and non-clinical adult populations. Disposition to CSB has been shown to influence adolescence sexual behaviors, but the development of adolescents' disposition toward CSB has yet to be examined in the family context. In this study, we investigated whether parent-adolescent communication mediates the links between parental characteristics and adolescents' CSB.

METHODS

The sample included 275 Israeli families [triad of mothers (age = 34-63 years, M = 45.48, SD = 5.46), fathers (age = 36-83 years, M = 48.33, SD = 6.63), and one adolescent (48.2% boys, 51.1% girls; age = 14-18 years, M = 16.23, SD = 1.18)]. Parents completed measures of psychopathology, parental self-esteem, and parental self-efficacy, and adolescents completed measures of quality of sex-related communication and CSB.

RESULTS

The results indicate that, for girls, higher maternal self-esteem and lower psychopathology were linked with better sex-related communication and so with lower CSB. For boys, only parental religiosity was linked with the quality of sex-related communication and CSB, with religious parents having better communication than secular ones.

DISCUSSION

The findings provide an opportunity for researchers to gain a better insight into the dynamics of familial factors in the development of CSB among adolescents.

An Exploration of the Ecological Context of Low-Income, Urban African-American Adolescent Sexual Risk

Prior health disparities research has indicated that urban, low-income African-American families and adolescents experience ecological and environmental hardships that result in higher rates of engagement in risk behaviors. Contextual factors like community violence, socioeconomic status, and family processes, as well as limited sexual health knowledge, a psychological element, also contribute to high rates of sexual risk among urban African-American adolescents. However, protective factors like parental monitoring and parent-adolescent communication about sex may decrease sexual risk among this urban teen population. Therefore, the current study sought to explore the following research questions: (1) Is parent-adolescent communication about sex associated with adolescent sexual health knowledge?, (2) Is parent-adolescent communication about sex associated with parental monitoring?, (3) Are parental monitoring and parent-adolescent communication about sex predictors of adolescent sexual risk?, (4) Are there gender differences in parent-adolescent communication about sex and parental monitoring?, and (5) Are age and gender predictors of adolescent sexual risk? A sample of approximately 1102 African-American adolescents aged 13-17 from urban Midwestern high schools were included in this study. There was no significant association found between sexual health knowledge and parent communication about sex or parental monitoring. Female adolescents reported higher levels of communication about sex than males. Findings indicated a significant negative association between parental monitoring and adolescent sexual risk, with the association being stronger for males than females. There was a significant negative association found between sexual health knowledge and adolescent sexual risk. Additionally, findings indicated a significant negative association between parental monitoring and adolescent sexual risk.

Mother-Daughter Sexual Communication: Differences by Maternal Sexual Victimization History

Women who experience childhood sexual victimization (CSV) report more problems with sexuality and with parenting during adulthood. Consequently, mothers with a CSV history may have particular difficulty with parent-child sexual communication. We examine this possibility in 184 diverse, low-income mother-adolescent daughter dyads. Mothers and daughters reported on the frequency, tone, and comfort of their sexual communication. Using dyadic approaches to analyses, we tested whether mothers' and daughters' reports, and their level of agreement, differ by maternal CSV history. In dyads with maternal CSV, daughters reported more frequent communication in which they felt less embarrassed, and they perceived their mothers as less embarrassed. Mothers with a CSV history were also more accurate in judging how their daughters feel during sexual communication. Although CSV is associated with many negative outcomes, our results suggest mothers with CSV may approach mother-daughter sexual communication in ways that could reduce sexual risk in offspring.

Longitudinal trajectories of perpetration of adolescent dating abuse in a national sample

Despite extensive research regarding patterns and outcomes of victimization in dating relationships, there has been limited investigation of the developmental profiles of the perpetration of adolescent dating abuse (ADA). We estimated longitudinal latent growth models of ADA perpetration in a sample of 2,269 U.S. adolescents/young adults ages 12-18 at baseline, drawing on four waves (2013-2017) of data from the nationally representative Survey of Teen Relationships and Intimate Violence. Model results revealed three classes representing "nondaters," respondents showing "increasing dating/ADA," and respondents with "high/stable dating/ADA." Results support prior research finding heightened patterns of ADA perpetration by older youth, and distinguish individual and family characteristics associated with adolescent/young adults' ADA perpetration for the purpose of informing individual and programmatic prevention efforts.

"You've Gotta be Careful": Familial Messages Regarding Sexual Behavior and Sexual Relationships among African American Adolescents

BACKGROUND

Research on the sexual behaviors of African American youth has primarily focused on associated risks, with a dearth of studies examining a fuller representation of African American adolescents' sexual lives. This study explored the range of messages African American adolescents receive from family members regarding sexual behavior and sexual relationships.

METHODS

Participants were 52 sexually experienced African American youth (male = 32, female = 20) between the ages of 15 and 17 recruited from community-based organizations in the United States. Youth participated in individual in-depth qualitative interviews, and data were analyzed using a phenomenological framework.

RESULTS

Participants received a variety of messages about sexual behavior and sexual relationships from a range of family members including parents, siblings, grandmothers, aunts/uncles, and cousins. Types of messages clustered into three domains: sexual decision-making, quantity and quality of sexual activity, and sexual health promotion; with themes and sub-themes emerging within each area.

CONCLUSION

Gender differences in the types of messages received are explored, and applications of the findings to the development of family-involved community interventions that promote sexual and reproductive health are discussed.

Vocational school students' self-evaluations of a sexual health promotion intervention

Sexually transmitted infections (STIs) continue to pose a health risk among adolescents. School is therefore a logical place for promoting sexual health through interventions, but previous research has not examined student's self-evaluations of these interventions. The purpose of this study was to examine students' self-evaluations of a sexual health promotion intervention carried out in four randomly selected vocational schools in Finland in the year 2011. The participants (n = 168) were first-year students aged 15-19 years. The intervention (11 weeks) consisted of three components: (i) a teacher-delivered classroom lesson about sexual health, (ii) information materials about sexual health and (iii) free condom distribution in the school corridors. An electronic questionnaire was developed and administered to the students after the intervention. The participants' evaluations of the intervention were fairly positive. Almost all of the participants were at least partly satisfied with the classroom lesson. They mostly reported learning new information about STIs and sexuality. Information material was also read and participants self-evaluated themselves as having learned from the materials. Free condoms were obtained and the students felt that the condom distribution was useful. Sexual health promotion interventions might in the future include the classroom lesson, information material and free condom distribution components used in this study.

Sexuality as taboo: using interpretative phenomenological analysis and a Foucauldian lens to explore fathers' practices in talking to their children about puberty, relationships and reproduction

Background

Fathers can play an important role in their children's learning about relationships and sexuality but we know very little about the father's lived experience in this regard.

Aim

To explore eight fathers' perceptions and experiences of discussing puberty, relationships and reproduction with their 10-year-old children.

Methods

The paper commences with a genealogical analysis of the history of sex education in England from the Public Health Act of 1848 to the present day. Interpretative phenomenological analysis (IPA) was used as both a methodology and a method. Face-to-face interviews were conducted with each father and results were analysed ideographically, followed by analysis across the group. Interpretations were developed using a Foucauldian lens of governmentality and biopower.

Findings

The paper explores how synthesis of IPA with a Foucauldian lens revealed significant tensions between the fathers' cognitions, accounts and behaviours, which were underpinned by an enduring perception of sexuality as taboo.

Conclusion

By providing a contextualised understanding of the fathers' practices, this study demonstrates that a more informed approach to health promotion strategy can be achieved and the implications for nursing are explored.